Verifying coverage of virtual services

Verifying coverage of virtual services to replace in-person visits and telehealth benefits

Telehealth expansion
Verify if your ASO patient’s employer group is covering expanded medical and behavioral health telehealth visits the same as in-person visits.

Follow these steps:

  • Check your Regence patient’s member ID card.
    • Your patient is part of an ASO group if their member ID card includes this language on the back in the lower left corner: Regence provides administrative claims payment services only and does not assume any financial risk or obligation with request to claims for medical services
  • View the list of ASO groups who have opted in to the telehealth expansion (PDF). Use the table below to help you understand the information in the list. Note: The ASO group list and table below indicate groups who have opted in to the telehealth expansion through September 30, 2020. ASO groups will be receiving a letter in October asking them if they’d like to extend their group’s coverage for expanded telehealth through December 31, 2020. The ASO group list and table below will be updated as information about our ASO group’s coverage becomes available.

Helpful information when reviewing the List of ASO groups who have opted in to temporarily cover telehealth visits the same as in-person visits

Answer in the column: Telehealth Expansion (3/19/20 – 6/30/20)

• Indicates if an employer group selected to temporarily cover telehealth visits the same as in-person visits from March 19 through June 30, 2020

Answer in the column: Telehealth Expansion (3/19/20 – 9/30/20 or the state of emergency for the group’s state, whichever is later.)

• Indicates if an employer group selected to temporarily cover telehealth visits the same as in-person visits from March 19 through September 30, 2020 (or through the end of the state’s emergency declaration)

The ASO group’s coverage

• Indicates the ASO group's coverage based on the information in the two columns

Yes

Yes

The group has opted in to the expanded telehealth from March 19 through September 30, 2020.

Yes

No

The group has opted in to the expanded telehealth for dates of service from March 19 to June 30, 2020. The group may not have replied to the second expansion, so the “No” may be subject to change.

No

No

The group has opted out of the telehealth expansion or we have not received confirmation that they plan to offer this benefit expansion. The group may have a telehealth benefit.  If so, the standard telehealth benefits will apply.

N/A

Yes

The group joined Regence on July 1, 2020 and opted in to the temporary telehealth expansion starting on this date.

We are also working with our ASO group partners to cover expanded telehealth services that meet our criteria through December 31, 2020, when directed.

For ASO groups who have opted in to the expanded telehealth, we will apply the office visit cost share for telehealth visits if directed to do so by the ASO group. Claims with dates of service from August 1 to September 3, 2020, that were processed with the telehealth cost share will be reprocessed to apply the office visit cost share. For some groups, the telehealth cost share is higher than the office visit cost share, so you may need to reimburse members who paid a higher cost share.

Telehealth benefits
ASO groups may have telehealth benefits that were in place prior to COVID-19. If the group has not opted in to the expanded telehealth, they may use their telehealth benefits.

View all COVID-19 updates and resources.